De­tect­ing can­cer early can save your life

Jamaica Gleaner - - FEATURE - Na­dine Wil­son-Har­ris Gleaner Writer na­dine.wil­son@glean­erjm.com

IT HAS been more than two years now since *Pamela Jack­son’s doc­tor de­tected a lump in her breast and sug­gested she get a mam­mo­gram, but the 59-year-old house­hold worker is yet to fol­low through on this ad­vice.

“He said there was a lump and I should go and get it tested to find out if it was can­cer­ous,” she said.

But Jack­son, who did a mam­mo­gram just a year be­fore her physi­cian’s as­sess­ment, in­sisted there was no need to get the screen­ing test, which doc­tors warn could make the dif­fer­ence be­tween life and death for those with can­cer.

“There was an­other doc­tor who told me I could do it my­self, and she told me what I could do when I go to the bath­room or a lie down, or what­ever, and I did it and I didn’t feel any­thing, re­ally,” she told The Sun­day Gleaner.

“You can self-test it and don’t feel any­thing there. I did that test (mam­mo­gram), and be­lieve me, it was hot [painful], and that kind of turn me off, hon­estly,” added Jack­son, who wit­nessed first hand the dev­as­tat­ing impact of can­cer from nurs­ing her cousin, who was di­ag­nosed with lung can­cer a year ago. He died re­cently.

De­spite sev­eral ed­u­ca­tion cam­paigns to am­plify the mes­sage that early de­tec­tion saves lives, ex­ec­u­tive di­rec­tor of the Ja­maica Can­cer So­ci­ety (JCS) Yulit Gor­don finds that the num­ber of women who are be­ing screened is nowhere near where it should be. The JCS screens about 10,000 per­sons an­nu­ally for breast can­cer, al­though the num­ber of Ja­maican women be­tween the ages of 40 and 75 years who need ac­cess to mam­mog­ra­phy screen­ing cur­rently stands at 400,000. “For Ja­maica to have the level of impact that is needed to re­duce the in­ci­dence of and mor­tal­ity to this dis­ease, we need to be screen­ing, as a coun­try, ap­prox­i­mately 40,000 women an­nu­ally,” she said. “The ma­jor bar­ri­ers that pre­vent most Ja­maican women from ac­cess­ing mam­mo­grams are the psy­cho­log­i­cal bar­rier of fear, fi­nan­cial bar­rier of cost, ge­o­graph­i­cal bar­rier of ac­cess.” Gor­don said the not-for-profit or­gan­i­sa­tion has ex­panded its health pro­mo­tion pro­grammes to in­clude can­cer sur­vivors who share their sto­ries in the hope of in­spir­ing and mo­ti­vat­ing more women to face their fears. “We have had me­dia per­son­al­i­ties here that have video­taped them­selves get­ting it [mam­mo­gram] done just to show that while it can be dis­com­fort­ing for some women be­cause of the na­ture of their breasts, it is not painful, and it is not a lengthy process ei­ther. It is just a cou­ple min­utes that can give you a life­time with your fam­ily,” Gor­don stated.

TOO LATE

Mam­mo­grams are cur­rently not of­fered at pub­lic health care fa­cil­i­ties, and so a woman can ex­pect to pay as much as $15,000 to ac­cess one pri­vately. How­ever, the JCS has tried to make the cost less of a bur­den by ask­ing women to con­trib­ute $3,500 for a mam­mo­gram at their fa­cil­ity. Dr De­ria Corn­wall, who has worked

ex­ten­sively with can­cer pa­tients in her ca­pac­ity as a ra­di­ol­o­gist, is just as con­cerned about the re­luc­tance of many Ja­maicans to be screened reg­u­larly for can­cer. “We need to get peo­ple screened to pick up the can­cer early be­cause in Ja­maica, we are pick­ing up can­cers late,” she said. “A lot of peo­ple wait un­til they go to the doc­tor be­fore they get screened and we tell peo­ple like women who are over 40, once you reach the age, you don’t need to go to a doc­tor to get per­mis­sion to go and do your mam­mo­gram,” ex­plained the ra­di­ol­o­gist, who lamented the fact that some peo­ple wait un­til they feel a lump be­fore they get screened. Al­though the strug­gle to get women screened ex­ists, Gor­don is pleased that there has been a vast im­prove­ment in the num­ber of men com­ing for­ward to be screened for prostate can­cer. There was a 250 per cent in­crease in the num­ber of men screened for prostate can­cer be­tween 2010 and 2015. Ac­cord­ing to Ja­maica’s Can­cer Registry, the most com­mon can­cers in women are breast, cer­vi­cal, and colon can­cer, while in men it is prostate, lung, and colon. For­tu­nately, the last re­port from the registry showed a de­crease in the in­ci­dences of both lung and can­cer of the cervix and the fig­ures are ex­pected to dip lower with the con­tin­ued re­duc­tion in the use of to­bacco and the in­crease in Pap smears for cer­vi­cal can­cer screen­ing.

While the World Health Or­gan­i­sa­tion has pre­dicted that new can­cer cases would rise from 14 mil­lion an­nu­ally in 2012 to 22 mil­lion within the next two decades, it is not known how many per­sons have been di­ag­nosed with can­cer in Ja­maica in re­cent times. The last can­cer in­ci­dent re­port for Ja­maica was pub­lished in 2010 and only cov­ered cases in Kingston and St Andrew be­tween 2003 and 2007. Dur­ing that five-year pe­riod, 4,981 cases were recorded.

Ac­cord­ing to data pro­vided by the National Health Fund, more than 21,000 Ja­maicans are cur­rently be­ing as­sisted by the Fund (NHF) to get treat­ment for can­cer. The NHF pro­vides drug sub­si­dies for those with breasts and prostate can­cer. The Fund also sub­sidises the cost for breast can­cer re­cep­tor stud­ies, which is a di­ag­nos­tic pro­ce­dure used by clin­i­cians to de­ter­mine the type of treat­ment ther­apy that is ap­pro­pri­ate for each pa­tient. The NHF has spent ap­prox­i­mately $2.6 bil­lion in can­cer treat­ment sub­sidy since 2003.

For Ja­maica to have the level of impact that is needed to re­duce the in­ci­dence and mor­tal­ity to this dis­ease, we need to be screen­ing, as a coun­try, ap­prox­i­mately 40,000 women an­nu­ally.

Yulit Gor­don, ex­ec­u­tive di­rec­tor of the Ja­maica Can­cer So­ci­ety.

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